Abstract: FR-PO976
Impact of Oral Spherical Carbon Adsorbent in Predialysis CKD on Cardiovascular Outcomes and Mineral-Bone Disorder After Dialysis Therapy
Session Information
- CKD Interventions: Trials and Quality Improvement
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Jeon, Hee Jung, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Korea (the Republic of)
- Kweon, Takhyeon, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Korea (the Republic of)
- Kee, Younkyung, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Korea (the Republic of)
- Shin, Dong Ho, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Korea (the Republic of)
- Oh, Jieun, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Korea (the Republic of)
Background
Oral spherical carbon adsorbents (OSCA) are known to slow the progression of chronic kidney disease (CKD) by inhibiting the absorption of uremic toxins produced in the intestine. In this study, we evaluated the impact of using OSCA in pre-dialysis CKD patients on cardiovascular outcomes and mineral-bone disorder after dialysis therapy.
Methods
This study was a retrospective cohort study that enrolled patients who started dialysis therapy including hemodialysis and peritoneal dialysis at Kangdong Sacred Heart Hospital. A total of 294 patients were included in this study, including 98 CKD patients who were administered OSCA before dialysis therapy (OSCA group) and 196 patients who were not administered OSCA with 1:2 matching by age and sex (control group).
Results
The mean age was 62.2 ± 12.7 years, with 60.2% male, and the most common cause of CKD was diabetes (67.0%). The ejection fraction in the echocardiogram was significantly higher in the OSCA group (58.1 ± 9.1 % vs. 55.5 ± 9.9 %, P = 0.033). The cardiovascular events in the control group were higher than those in the OSCA group, however, there were statistically not significant (26.0% vs. 19.4%, P = 0.266). However, the patients who were administered OSCA for more than 113 days showed significantly fewer cardiovascular events after dialysis therapy than those less than 113 days (P = 0.032 by log-rank test), which remained significant in multivariate cox regression analysis (HR 1.48, 95% CI 1.05-2.08, P = 0.025). There was no difference in bone mineral density, pulse wave velocity, bone-specific alkaline phosphatase, parathyroid hormone, and 25(OH)vitamin D levels. In the subgroup analysis of diabetes, all-cause mortality was significantly lower in the OSCA group (27.1% vs. 12.7%, P = 0.029).
Conclusion
The administration of OSCA in CKD patients before dialysis tended to reduce the incidence of cardiovascular events after the start of dialysis therapy, and the longer the period of administration of OSCA, the more significant difference was shown.
Funding
- Commercial Support – Daewon Pharmaceutical Co., Ltd.